Oregon Fatality Assessment Control Evaluation FACE Annual Report Occupational by sarahmccarthy

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									      Oregon
Fatality Assessment
& Control Evaluation
       (FACE)

   Annual Report
       2004



 Occupational Fatalities
Acronyms

BLS            Bureau of Labor Statistics, U.S. Department of Labor
CFOI           U.S. Census of Fatal Occupational Injuries
DCBS           Oregon Department of Consumer and Business Services
OR-OSHA        Oregon Occupational Safety and Health Division
SAIF Corp      State Accident Insurance Fund (Workers’ Compensation)


Oregon Fatality Assessment and Control Evaluation (OR-FACE) is funded by the National
Institute for Occupational Safety and Health (NIOSH), through the Oregon Department of Human
Services (DHS). The program is administered by the Center for Research on Occupational and
Environmental Toxicology (CROET) at Oregon Health and Science University (OHSU).
Oregon                                        This report is dedicated to the men and
Fatality Assessment
& Control Evaluation                          women in Oregon who have lost their lives


                                              as the result of traumatic workplace injuries,
Annual Report 2004

                                              in the hope that better understanding of
Table of Contents

FACE Definitions ................... 4
                                              these fatal incidents may help to save the
Summary/Introduction .......... 5
                                              lives of other workers in similar situations.
OR-FACE Network ................. 6

Surveillance ........................... 7

OR-FACE Publications .......... 8

Investigation .......................... 9

Assessment ......................... 10

Outreach ............................... 11

Hazard Alerts .................. 12-13

Charts .............................. 14-18

Abstracts ......................... 19-31

Contact Information ............ 31


                                              OR-FACE Program
                                              OHSU/CROET
                                              GARY RISCHITELLI MD JD MPH
                                              JOAN ROTHLEIN PHD
                                              TERRY HAMMOND MPH
                                              AVIE MEADOWS BS
Website:                                      Oregon DHS, Public Health Services
www.ohsu.edu/croet/face
                                              MICHAEL HEUMANN MA MPH
e-mail:
oface@ohsu.edu                                The Oregon FACE program is supported by
                                              NIOSH Cooperative Agreement OH008324-03

                                              3
                                      FACE Definitions


T   he Oregon Fatality Assessment and Control Evaluation program investigates work-related
    fatalities that are caused by a traumatic injury when the injury occurs within Oregon.
A location within Oregon means the incident, or some portion of the incident, occurs within
the geographical boundaries of the state of Oregon, including the coastal waters, airspace, and
subterranean portions of the state.
A work relationship exists if an incident occurs (a) on the employer’s premises and the person was
there to work, or (b) off the employer’s premises and the person was there to work, or the event or
exposure was related to the person’s work or status as an employee.
Work is defined as duties, activities, or tasks that produce a product or result, are done in exchange
for money, goods, services, profit, or benefit, and are legal activities.

In Scope
•    Self-employed, family or volunteer workers who are exposed to the same work hazards and
     perform the same duties or functions as paid employees and that meet the work-relationship
     criteria
•    Suicides and homicides that meet the work-relationship criteria
•    Fatal events or exposures that occur when a person is in travel status, if the travel is for work
                                                   Introduction
     purposes or is a condition of employment (excluding commute)

Out of Scope
•    Institutionalized persons, including inmates of penal and mental institutions, sanitariums,
     and homes for the aged, infirm and needy, unless they are employed off the premises of their
     institutions
•    Fatal heart attacks and strokes, unless causally related to a traumatic injury or exposure
•    Fatal events or exposures that occur during a person’s recreational activities that are not
     required by the employer
•    Fatal events or exposures that occur during a person’s commute to or from work

Adapted from Bureau of Labor Statistics (2001), Census of Fatal Occupational Injuries: Definitions.
U.S. Department of Labor. Available online (March 11, 2004): http://stats.bls.gov/iif/oshcfdef.htm




                                                           4
                                               Summary


O     R-FACE recorded 60 fatal occupational
      incidents in 2004, with 61 worker deaths.
Each incident is investigated sufficiently to
                                                                              Introduction

                                                           Oregon Fatality Assessment & Control Evaluation
                                                           began recording traumatic occupational fatalities
produce an abstract of the event. Investigation
                                                           in Oregon in 2003, becoming one of 15 states in
reports are produced according to a list of priority
                                                           the nation to participate in a fatality surveillance
areas, specified partly by NIOSH, in combination
                                                           and assessment program sponsored by the
with areas of local concern to Oregon.
                                                           National Institute for Occupational Safety and
Priority Areas                                             Health.
•   Machine-related
                                                           In 2004, OR-FACE recorded 60 fatal occupational
•   Logging and forestry
                                                           incidents, and 61 worker deaths. These numbers
•   Construction
                                                           are lower than the 63 incidents and 76 deaths
•   Street and highway work zones
                                                           recorded in Oregon in 2003.
•   Agriculture
•   Minority workers                                       In 2004, the occupational fatality rate in Oregon
•   Youth (under age 18)                                   was 3.5 per 100,000 employed workers in the
                                                           civilian labor force, compared to 4.5 per 100,000
Other areas may also produce compelling
                                                           in 2003. The lower rate in 2004 is due mostly to
incidents. Electrocution appears among the 2004
                                                           fewer incidents with multiple fatalities. Nationally,
investigation reports published to date, as well as
                                                           the occupational fatalitiy rate increased in 2004,
an incident of exposure to carbon monoxide.
                                                           rising from 4.0 to 4.1 per 100,000 workers (CFOI
A traumatic injury is a specific incident within a          2004).
single work day that produces an unintentional
or intentional wound or damage to the body. Six            Many of the characteristics of fatal incidents in

basic types of event are recognized.                       Oregon in 2004 are similar to 2003. Hazard alerts
                                                           this year draw attention again to logging, mobile
•   Transportation                                         machinery, and transportation (see p. 12-13).
•   Contact with objects or equipment
•   Exposure to harmful substances/environment             An additional area of concern in 2004 involves the

•   Falls                                                  large number of fatalities among older workers.

•   Violence                                               Fatality rates were elevated for workers aged
                                                           55-64, and were exceptionally high for workers
•   Fire and explosions
                                                           aged 65 and over. Senior workers comprise about
A few changes appear in coding transportation              3% of the labor force in Oregon, but comprised
incidents in 2004. To draw out underlying                  20% of all occupational fatalities in 2004 (12 of
variety, occupation and event charts now show              61). Nationally, senior workers comprised 10%
transportation in four divisions: motor vehicles,          of total occupational fatalities in 2004, or half the
mobile machinery, air, and water transportation.           rate indicated in Oregon.


                                                       5
                                  OR-FACE Network

   Federal Agencies                                       State Agencies
   National Institute for Occupational Safety
                                                          Department of Consumer & Business Services
     and Health
                                                            – Census of Fatal Occupational Injuries
   Occupational Safety and Health
     Administration                                         – Oregon Occupational Safety and Health
                                                                   Administration
   National Transportation Safety Board
                                                            – Information Management Division
   Bureau of Land Management
                                                            – Workers’ Compensation Division
   U.S. Coast Guard
                                                          Department of Human Services
   Federal Aviation Administration
                                                            – Center for Health Statistics
   U.S. Forest Service
                                                            – Public Health Services
   Mine Safety and Health Administration
                                                          Employment Department
   Associations and Firms                                 Bureau of Labor & Industries
   Associated Oregon Loggers                                – Wage & Hour Division: Child Labor
   Oregon Farm Bureau                                     State Police
   SAIF Corporation (Workers’ Comp)                         – Medical Examiner’s Office
   Liberty Northwest (Workers’ Comp)                        – State Fire Marshal
   Oregon Trucking Association                            Department of Transportation
   American Society of Safety Engineers                     – Department of Motor Vehicles
   Association of General Contractors                     Department of Forestry
   American Industrial Hygiene Association                FACE programs in other states
   American Association of Occupational
     Health Nurses                                        Local Agencies
                                                          Medical examiners, county sheriff offices
   American College of Occupational and
    Environmental Medicine                                Portland Police Bureau
                                                            – Traffic Investigation Unit
   Oregon Labor Safety & Health Education
                                                          Portland Fire Bureau
     Program
                                                          County health departments
   Oregon AFLCIO
                                                          Local fire departments


OR-FACE incidents investigated by other safety
agencies, 2004             NTSB
                                            Other/None
                                                                                              (29) 48%
                                                              (2) 3%

                                                   Federal
                                                 OSHA/MSHA
                                                    (3) 5%




OSHA = Oregon or U.S. Occupational
         Safety & Health Administration             Oregon OSHA
                                                      (26) 43%
MSHA = Mine Safety & Health Administration
NTSB = National Transportation Safety Board
Other/None = Sheriff, police, U.S. Coast Guard, military, or none




                                                      6
                                          Surveillance


C     omprehensive OR-FACE surveillance of
      traumatic occupational fatalities expands
upon other surveillance systems in the state.
                                                              (BLS Standard Occupational Classification), and
                                                              event code (BLS Occupational Injury and Illness
                                                              Classification). Standardized coding facilitates
OR-FACE fatality assessment increases relevance               national comparisons, and assists in analysis
to local working conditions by including all                  and presentation of data (see charts p. 14-18).
incidents that occur within Oregon, whether or not            Additional information is composed in abstracts
the worker is an Oregon resident.                             for each incident, with details that identify types
                                                              of equipment, behavior, and environmental
OR-FACE information sources include death
                                                              factors.
certificates, law enforcement and medical
examiner reports, news reports, and OR-OSHA                   First notification for OR-FACE incidents
and other investigation reports when available.               was supplied by (a) state agencies, (b) death
Nearly half of all 2004 occupational fatalities               certificates, and (c) news media. In 2004,
recorded by OR-FACE were not recorded by                      OR-FACE was notified within 2 days of a fatal
OR-OSHA or national safety agencies. Most of                  incident in nearly one-third of the cases, mostly
the additional incidents captured by OR-FACE                  by OR-OSHA. All first notification received from
involve transportation incidents, or self-employed            OR-OSHA occurred within 30 days.
or family farm workers.
                                                              Later notification was mostly supplied by death
Data regarding OR-FACE incidents are collected                certificates, identified as work-related by Oregon
in a customized Access database, including basic              DHS Center for Health Statistics. News media and
information about incident, employer, and victim.             Oregon DCBS (including Workers’ Compensation
Incidents are coded in the database according to              and Oregon Census of Fatal Occupational
NAICS industry code (North American Industry                  Injuries) supplied regular notification for incidents
Classification System), SOC occupation code                    for up to 12 months following an incident.



  Source of notification for OR-FACE incidents, 2004
    News media                       Death Certificates
     (10) 16%                            (20) 33%

                                                         Timing of notification following incident
                                                                                 Oregon    Death       Oregon   News
                                                                         Total   OSHA     Certificate   DCBS     Media
                                                         0-2 days          17        10            -        2           5
                                                         3-30 days         14         9           1         2           2
                                                         1-3 months          2        -            -        1           1
                                                         3-6 months        14         -          12         2           -
   Oregon Dept                                           6-12 months       12         -           7         3           2
  of Consumer &
 Business Services                  Oregon OSHA
     (11) 18%                         (19) 31%




                                                          7
                        OR-FACE Publications 2004

                                Fatality Investigation Reports

2004 Incidents
•   Fabricator killed by ruptured hydraulic press fitting
•   Janitor using propane buffer killed by carbon monoxide
•   Machine operator electrocuted while shoveling pellets
•   Parked forklift crushes operator against semi-trailer
•   Forklift crushes operator working underneath on starter
•   Nursery laborer killed in skid-steer loader
•   Sawmill worker crushed during debarker maintenance

2003 Incidents
•   Worker killed in wood-dust fire sparked by faulty fuse
•   Operator killed when bulldozer slides off logging road
•   Logger killed by falling sheave when yarder tower collapses
•   Farm driver overturns truck in irrigation ditch and drowns
•   Logger killed as skyline cable whips free of slash pile
•   Effort to clear rock jam in operating rock crusher fatal


                                             Hazard Alert
•   Parked vehicles kill


                                                 Other
•   Annual Report 2003


Find published reports and other information at the OR-FACE website
(www.ohsu.edu/croet/face). New reports are published regularly.

Oregon Fatality Assessment and Control Evaluation reports are for information, research, or
occupational injury control only. OR-FACE is a research program, and has no legal authority to
enforce state or federal occupational safety and health standards. The identity of the decedent,
employer, and witnesses are not included in reports or alerts.
FACE data are protected from disclosure under Oregon law. Data collected by the Oregon Department of
Human Services in connection with special morbidity or mortality studies are confidential and may be used
solely for the purpose of the study (ORS 432.060).

                                                     8
                                           Investigation


O     R-FACE investigates incidents according
      to priority areas defined by the National
Institute for Occupational Safety and Health, in
                                                          Full investigations typically resulted in a
                                                          published report. Partial investigations provided
                                                          background information in files for producing
combination with additional priorities important to       abstracts and hazard alerts. Actual or pending
Oregon.                                                   legal action in an incident sometimes prevented
                                                          access to information.
Priority Areas
•   Machine-related                                       Most investigations during 2004 were conducted
                                                          by a full-time OR-FACE investigator. By the end
•   Logging and forestry
                                                          of 2004, OR-FACE developed a new system,
•   Construction
                                                          using an independent consultant to provide
•   Street and highway work zones
                                                          expert advice for logging incidents. The new
•   Agriculture
                                                          contract arrangement facilitated the completion
•   Minority workers
                                                          of investigations and reports related to three 2003
•   Youth (under age 18)                                  logging incidents.

A full OR-FACE investigation includes an onsite           Later, an independent investigator was
visit, interviews with employers, employees,              contracted for other industrial sectors. The use of
and witnesses, and consultation with other                independent contractors has worked well, and is
investigators and investigative reports.                  now standard practice for all investigations.




                                                      Incident Report Status 2004
                                                           7     Reports published
                                                          4      Draft in review
                                                           9     Active
                                                                 (potential interest)

                                                          40     Abstract only
                                                                 (no investigation)

                                                      An abstract is produced for each
                                                      incident (see p. 19-30).


                                                      9
                                              Assessment


O     R-FACE is a research and education
      program, and is not designed to assign
blame or enforce rules. Investigation reports and
                                                         Reports are designed with a striking front
                                                         page – including an abstract, photograph, and
                                                         recommendations – to provide a quick, accessible
hazard alerts follow the NIOSH outreach strategy,        summary and encourage posting on bulletin
incorporating three basic elements: a narrative          boards. Photographs and drawings are used inside
summary, safety recommendations, and artwork.            to illustrate technical details.

The story of each loss of life is a lesson.              OR-FACE has published seven investigation
OR-FACE investigation reports produce a                  reports for 2004 incidents, plus six additional
narrative description of the fatal incident that         reports for 2003 incidents. Two of the reports
includes information about the employer,                 address yarding operations in logging – a primary
coworkers, equipment, and safety training. Safety        area of concern. At the end of 2004, a one-page
recommendations provide a brief “take-home”              hazard alert – “Parked Vehicles Kill” – was
message. Each report concludes with a discussion         produced in response to seven incidents involving
of the recommendations.                                  movement of a parked vehicle.

Recommendations are drafted by the OR-FACE               A significant new activity in 2004 involved
investigator and research editor, with input             analyzing the first full year of data for 2003
from manufacturer and industry standards, and            incidents. Dramatic personal stories were
consultation with safety professionals and other         decomposed into data elements, aggregated into
investigators. The recommendations are finalized          charts, and used in the annual report, conference
in a collaborative review by the OR-FACE team            presentations, and other publications.
and an independent panel of occupational safety
and injury prevention experts.


                                                                   Fatality Alert

                                                                   Parked vehicles kill
                                                                   Parked vehicles killed seven workers in Oregon in

                                                                   less than 1 year, through 2004. REMEMBER, your

                                                                   vehicle could unexpectedly move, even if you are not

                                                                   in it. Please observe the following safety tips.

                                                                   Recommendations

                                                                   • Shut down engine before exiting vehicle,                                      • Do not trust the stability of heavy mobile
                                                                      and engage parking brake.                                                      machinery on an incline.

                                                                   • Lower blade or forks to the ground on                                         • Block tires before working beneath a
                                                                     mobile machinery to promote stability                                           vehicle.
                                                                     before exiting.
                                                                                                                                                   • You are not a superhero. Do not try to stop
                                                                   • Fix a faulty parking brake right away.                                          a rolling vehicle with your body.

                                                                   Fatal Incidents                                                                 when the pickup would not start again. The transmission was in neutral.
                                                                                                                                                   The event was not witnessed, but the logger may have been underneath
                                                                   Runaway tow truck A tow truck driver was killed while trying to stop his        the vehicle trying to fix the starter, which had just been replaced the day
                                                                   runaway tow truck. Two weeks earlier, the brake on the truck had failed at      before and was not working properly. The victim was reportedly aware that
                                                                   a service station, and the driver had to jump in and stop it. This apparently   the parking brake on the pickup was not functioning for several months
                                                                   happened again on an inclined road outside a wrecking yard. The driver          prior to the incident.
                                                                   tried to enter the cab while the truck was rolling. He was dragged about 30
                                                                   ft before striking a parked car, He was crushed between the door and cab        Ranch bulldozer A ranch hand was killed while operating a D4E
                                                                   of the tow truck.                                                               Caterpillar in a bulldozer logging operation. The ranch hand was an
                                                                                                                                                   experienced logger and was in the process of yarding logs. With the
                                                                   Parked forklift A forklift operator was crushed when the forklift he had        engine running, parking brake set, and the front blade raised about 1 ft off
                                                                   been operating engaged in reverse and crushed him against a semi-               the ground, the ranch hand was busy setting chokers behind the bulldozer.
                                                                   trailer. To assist a truck driver in tying down a new load, the operator        The bulldozer was on a slight incline and the tracks were on branches,
                                                                   backed the forklift to the opposite side of the trailer, pushed the automatic   which may have contributed to instability. As the ranch hand leaned down,
                                                                   transmission into neutral, engaged the parking brake, and jumped out            the bulldozer dislodged and slid backward over him.
                                                                   to take the strap thrown across the load. The forklift’s engine was left
                                                                   running. While the operator was facing the trailer and busy with the strap,     Moving bus A bus driver was run over by the city bus she had been
                                                                   the forklift unexpectedly engaged in reverse and backed into him with           driving. The driver exited the bus to take a scheduled break at a transit
                                                                   enough force to make the trailer shudder.                                       center. She left the engine running, and walked to the driver’s side to
                                                                                                                                                   reach in the window, probably to close the door as is common practice
                                                                   Fixing starter A construction contractor operating a rough-terrain forklift     among drivers. The bus began to move forward, and the driver ran to the
                                                                   was run over and killed while he was working underneath the machine.            front with outstretched arms, apparently trying to stop the 15-ton vehicle.
                                                                   The contractor apparently did not know the forklift would not start when        The bus ran over her. How the bus could have moved forward on flat
                                                                   left in gear, and he was using a screw driver, trying to fix the starter.        ground remains uncertain. The parking brake was apparently set, which
                                                                   The screwdriver made contact between the two terminals on the starter,          prevents the bus from moving even when in gear.
                                                                   effectively jump-starting the engine and bypassing the safety mechanism
                                                                   that prevented ignition while in gear. The parking brake had not been set,      Fixing brakes A semi-truck driver was killed while
                                                                   and the forklift rolled over the contractor.                                    working on his front brakes at a truck stop. The driver
                                                                                                                                                   asked another driver to get in and start the engine, while
                                                                   Runaway pickup A logger was killed at an active logging site by a               he was still underneath the vehicle. The transmission
                                                                   pickup truck. Apparently the engine stalled, and the logger exited the cab      was engaged, and turning the starter caused the truck to
                                                                                                                                                   lurch forward. The front tire ran over the driver.


                                                                     O R - FAC E              PLEASE POST
                                                                                                                       Oregon Fatality Assessment and Control Evaluation
                                                                                                                                              503-494-2502 www.ohsu.edu/croet/face




                                                    10
                                                Outreach


P    ublication and circulation of safety materials
     to relevant audiences raises awareness of
hazards, contributes to the normative environment
                                                           One indication of OR-FACE publications
                                                           reaching the intended audience was observed
                                                           in the use of an investigation report from the
for occupational safety, and may produce tangible          OR-FACE website. A 2004 report on a sawmill
results in policy and behavior.                            fatality (OR 2004-03) was found online and
                                                           distributed by the Alberta Forest Products
OR-FACE investigation reports and other                    Association to its members as a hazard alert.
publications are available on the OR-FACE
website, and are also distributed in targeted              In September 2004, OR-FACE data for 2003
electronic mailings to public agencies, safety             was finalized and prepared for publication in the
professionals, and relevant employers and                  OR-FACE 2003 Annual Report. Data charts were
associations. Interested persons may add their             also published in the CROET quarterly newsletter
names to the mailing list online. OR-FACE                  (circ. 15,000), and in a safety newsletter of
investigation reports are also linked to specific           Hewlett-Packard, Corvallis, which was distributed
industry topics on the CROET online                        to all employees.
occupational safety and health resource directory
                                                           OR-FACE fatality assessment results were also
(www.CROETweb.com).
                                                           presented at several safety and health conferences
OR-FACE collaborates with NIOSH and other                  in 2004. Four exposure events in 2003-04,
state-based FACE programs by submitting a                  for example, were compiled for a conference
monthly report of Oregon fatality surveillance             presentation, “Their Last Breath,” which discussed
and outreach activities. All investigation reports         different mechanisms of fatal exposure.
are submitted to the national FACE online library
(www.cdc.gov/niosh/face).                                  OR-FACE website: www.ohsu.edu/croet/face




                                                      11
                                       Hazard Alerts


Logging                        Worker Fatalities by Setting, 2004
                       0                                2                                   4


              Faller



           Yarding



   Other transport



        Log trucks



The logging industry in Oregon remains the most hazardous working environment in the state.
Including log truck drivers and all self-employed workers, about 9,219 workers in Oregon were
employed in direct logging occupations. With 11 fatal incidents in logging in Oregon in 2004, the
rate of occupational fatalities was 119 per 100,000 workers, about the same as in 2003. Fallers
are most at risk, with a rate of 221 per 100,000 workers. Several of the fallers involved in fatal
incidents were very experienced. Yarding incidents involved a range of occupations, including a
helicopter pilot, a bulldozer operator, and a chaser.


Mobile Machinery                           Worker Fatalities by Vehicle, 2004
                           0                2                    4                     6


         Forklift-type


   All-terrain Vehicle


   Crane/Drilling Rig


           Bulldozer


        Farm Tractor


Mobile machinery remains a prominent area of concern in 2004, mostly involving forklift-type
vehicles. Half of the six forklift incidents occurred during normal operation of the vehicle. The
remaining three incidents occurred while the forklift was parked, emphasizing hazards for the
operator or others outside or under the machine. The bulldozer incident also involved a parked
machine that was not completely stabilized before exiting the cab. Two ATV incidents appeared in
2004, one involving a 16-year-old dog trainer riding without protective gear.

                                                  12
                                    Hazard Alerts


Transportation                   Worker Fatalities by Vehicle and Setting, 2004

                           0                   2                     4                    6

       Auto/Pickup/Van
        - Paved Road

               Truck
           - Paved Road

       Operator Outside/
          Pedestrian

          Pickup/Truck
        - Unpaved Road


      Air Transportation


   Water Transportation



Transportation incidents represented 43% of all occupational fatalities in 2004, nearly the same
as in 2003. The percentage involving trucks increased; water incidents with fishermen decreased.
There were fewer events with multiple victims than in 2003. Of particular concern, 5 of 19 motor
vehicle incidents involved the operator or a pedestrian outside the vehicle.


Older Workers                    Fatalities by Event for Older Workers, 2004
                           0                              4                               8


         Transportation


                   Falls


                Contact


               Violence
                                                                    Age 55-64   Age 65+
    Transportation (Air)


The age distribution of fatal incidents in 2004 showed a marked increase among older workers,
particularly for those aged 65 and over. Compared to all younger workers, a fatal incident was
somewhat more likely for workers aged 55-64, but 8 times more likely for workers aged 65 and
over (see age chart, p. 14). Falls were the most common event. The incidence of suicide reflects
a concern in Oregon for elevated rates of suicide among the elderly in the general population.

                                                   13
                                                               Charts


T       he following charts present aggregate data
        on occupational fatalities in Oregon in 2004.
A notable rise occurred in 2004 in the proportion
                                                                           Worker Fatalities by Race/Ethnicity, 2004
                                                                                            Hispanic
                                                                                             (4) 7%
                                                                                                              White
                                                                                                          (no ethnicity
                                                                                    Asian                  specified)
                                                                                   (2) 3%                   (55) 90%
of female workers involved in fatal incidents.
The percentage of female fatalities was 15% in
2004, and only 4% in 2003. The national average
of female fatalities is 7%. Combining years, the
average number of female fatalities in Oregon fits
a normal range – occurring at a rate much lower
than for males. Hazardous occupations are clearly
sorted by gender.


   Worker Fatalities by Gender, 2004                                       Distinguishing worker fatalities by race/ethnicity
                       Female                                              generally reflects the composition of the Oregon
                       (9) 15%
                                                                           population. The 7% of incidents that involved
                                                                           Hispanic workers nearly reaches the 8%
                                                                           proportion of the population. The 3% of incidents
                                                                           that involved Asian workers also reflects the
                                                                           proportion in the general population. In 2004, no
                                                                           incidents occurred involving Native American

                                                     Male
                                                                           workers, and in the past 2 years no incidents have
                                                   (52) 85%
                                                                           occurred involving African American workers.


                                  Occupational Fatalities in Oregon by Age, Compared to
                                  Age Distribution of Civilian Labor Force in Oregon, 2004
                       30%


                       25%
                                                                                                            Occupational
                                                                                                            Fatalities
                       20%
    Percent of Total




                                                                           16
                                                                                                            Total Labor
                                                                                                            Force
                       15%                                                                       12
                                                                                                           Labor force
                                                               10                                       computed from US
                                                                                                          Census 2000
                       10%                         8

                                                                                     9                         Number of
                        5%                 5                                                                   fatalities
                                   1


                        0%
                                 16-19   20-24   25-34        35-44     45-54      55-64        65+
                                                         Age Category

                                                                      14
                                                           Charts

                    Worker Fatal Incidents and Total Fatalities by Day, 2004

        16

                  Gray shows multiple fatalities per incident



        12




         8




         4




         0
                 Sun               Mon              Tue          Wed      Thu                Fri         Sat




          Worker Fatal Incidents and Total Fatalities by Time of Incident, 2004

16


                                                                            Gray shows multiple fatalities per incident
                                                                                  (time unknown in 3 incidents)

12




 8




 4




 0
       1:00-     3:00-     5:00-       7:00-   9:00- 11:00 AM- 1:00-       3:00-     5:00-       7:00-   9:00- 11:00 PM-
     2:59 AM   4:59 AM   6:59 AM     8:59 AM 10:59 AM 12:59 PM 2:59 PM   4:59 PM   6:59 PM     8:59 PM 10:59 PM 12:59 AM


                                                                15
  Occupational Fatality Rates in Oregon by County, 2004


   Clatsop           Columbia
                                          Hood
                           Multnomah      River                                         Umatilla
             Washington                                 Sherman                                             Wallowa
                                                                             Morrow
Tillamook                                                        Gilliam                           Union
              Yamhill        Clackamas

                                              Wasco                                                                    Fatality rate per
              Polk      Marion                                                                                         100,000 employees
                                                                Wheeler                               Baker
 Lincoln                                    Jefferson                                                                          0
               Benton        Linn                                                     Grant
                                                                                                                               0.1 to 5
                                                                                                                               5.1 to 10
                                                            Crook                                                              10.1 to 20
                                                                                                                               20.1 +
                           Lane
                                          Deschutes
                                                                                                       Malheur        Employment:
                                                                                                                      LAUS 2004
                                                                                                                      (employed civilian
Coos             Douglas                                                                                              labor force,
                                                                                      Harney
                                                                                                                      inclues farm and
                                                           Lake                                                       self-employed)

Curry                   Jackson
                                         Klamath
           Josephine




  Oregon Population, Employed Labor Force, and Fatalities by County, 2004

 County                          Total     Employed         Worker           County                      Total    Employed          Worker
                            population    labor force      fatalities                               population   labor force       fatalities

 OREGON TOTAL             3,582,600      1,718,507              61
 BAKER                       16,550          6,637                1          LAKE                     7,500         3,264                 1
 BENTON                      81,750        40,075                 1          LANE                   333,350      160,363                  3
 CLACKAMAS                  356,250       176,707                 2          LINCOLN                 44,400       20,048                  1
 CLATSOP                     36,400        17,474                 1          LINN                   106,350       47,204                  3
 COLUMBIA                    45,650        20,981                 2          MALHEUR                 31,850       11,929                  1
 COOS                        62,700        25,857                 3          MARION                 298,450      138,577                  2
 CROOK                       20,650          8,336                           MORROW                  11,750         5,279                 1
 CURRY                       21,150          8,653                1          MULTNOMAH              685,950      345,614                  9
 DESCHUTES                  135,450        66,293                 3          POLK                    64,950       32,461
 DOUGLAS                    102,350        43,381                 2          SHERMAN                  1,900           810                 1
 GILLIAM                        1,900          997                2          TILLAMOOK               24,950       11,356                  1
 GRANT                          7,750        3,467                1          UMATILLA                72,250       34,155                  2
 HARNEY                         7,650        3,122                           UNION                   24,850       11,261
 HOOD RIVER                  21,050        11,569                 1          WALLOWA                  7,150         3,266
 JACKSON                    191,200        91,815                 3          WASCO                   23,900       11,794                  1
 JEFFERSON                   20,250          8,356                3          WASHINGTON             480,200      247,482                  6
 JOSEPHINE                   78,600        31,547                            WHEELER                  1,550           609
 KLAMATH                     64,800        27,119                 3          YAMHILL                 89,200       40,649

 Population sources: Portland State University Population Research Center, LAUS 2004


                                                                        16
                                                             Charts

              Worker Fatal Incidents and Total Fatalities by Month and Season, 2004

 20                                                                                         0



 16                                                                                         6

                                     Gray shows multiple fatalities per incident

 12                                                                                         2



  8                                                                                         8



  4                                                                                         4



  0                                                                                         0
       Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec                                             Winter   Spring Summer Autumn



                     Worker Fatalities in Oregon by Occupation and Event, 2004
                                        0                     4                         8                       12                   16
 OCCUPATION
                     Transportation
                      Construction
                           Logging
         Install/Maintain/Repair
                      Management
                        Production
                 Material Moving
                       Farm/Ranch
                             Military
       Personal Care/Services
                 Sales & Related
      Arts/Design/Sports/Media
Building/Grounds Maintenance
             Education/Training
                            Fishing
          Food Prep & Related
                           Forestry
          Office/Admin Support
EVENT
   Transportation     Transportation        Transportation   Transportation   Contact       Fall     Exposure   Violence   Overexertion
   (Motor Vehicle)    (Mobile Machinery)    (Air)            (Water)


                                                                   17
                                            Charts

            Worker Fatal Incidents and Total Fatalities by Type of Event, 2004
                                    0   4            8            12                16                 20

              Contact with
           objects/equipment
              Transportation
              (Motor Vehicle)

                         Falls

            Transportation
          (Mobile Machinery)
       Exposure to harmful
      substance/environment

                     Violence
                                                         Gray shows multiple fatalities per incident

          Transportation (Air)


       Transportation (Water)


                Overexertion



                          Worker Fatalities in Oregon by Industry, 2004
                                0               4                            8                              12

              Manufacturing
            Forestry/Logging
              Transportation
                  Agriculture
                Construction
                Retail Trade
                      Mining
Admin/Support/Waste/Remed.
Accommodation/Food Services
              Other Services
        Public Administration
      Arts/Entertainment/Rec
                     Fishing
          Education Services
     Profession/Science/Tech

                                                18
                                Worker Fatalities


INFORMATION KEY


Description
                                         Abstracts
                               of fatal occupational incidents in Oregon
Industry
Occupation                                  by type of event
Date of Incident                                           2004
County of Incident                     Transportation – Contact – Exposure – Falls
OR-FACE Number
                                                 Violence – Overexertion



Transportation (Motor Vehicle)
Broken leg              A 48-year-old assistant manager for an agriculture supply firm died on
                        April 19, 2004, a little over 3 years after he was run over by a customer’s
Agriculture             1-ton flatbed truck while staking out an irrigation plot (Feb 26, 2001). The
Management              assistant manager was walking through the customer’s field when the
                        truck backed over him. He sustained severe leg injuries. Cause of death
February 26, 2001       was identified as “post phlebitic syndrome and pulmonary embolism.”
Umatilla
OR 2004-54-1

Wet road head-on        A 34-year-old Hispanic female nursery worker was killed on the highway
                        while traveling between farms. Conditions were wet and foggy. She
Agriculture             drifted into the opposite lane on a curve, and collided head-on with
Office/Admin Support     a delivery van. She was declared dead at the scene. The van driver
                        survived and was transported to a hospital.
February 9
Washington
OR 2004-41-1

Wet pavement            A 23-year-old sales representative for a family advertising business was
                        killed when he lost control of his SUV on the highway. On wet pavement,
Profession/Science/     the sales rep abruptly switched lanes toward an exit, lost control and
 Technology             struck a highway sign. The sales rep was apparently not using the
Sales & Related         seatbelt. Emergency responders confirmed the victim dead at the scene.

February 16
Multnomah
OR 2004-53-1

Taxidermy delivery     A 37-year-old taxidermist making a delivery of dry ice to a local hospital
                       died at the scene after his vehicle left the highway and rolled over about
Arts/Entertainment/Rec 4 a.m. Roads were icy and the tires worn. The taxidermist was not
Arts/Design/Sports     wearing a seatbelt and was thrown from the vehicle.

March 27
Deschutes
OR 2004-29-1


                                                19
                 Worker Fatalities – Transportation

Courier collision       A 56-year-old courier was killed while driving a full-sized delivery van
                        on the freeway. The courier evidently did not notice quickly enough that
Transportation          traffic ahead was slowing down. The van struck the rear of a flatbed tow
Transportation          truck, with the sharp edge of the truck bed about level with the bottom
                        of the van’s windshield. The van console was crushed and the airbag
June 3                  inflated. The driver’s seat was broken by the impact. The victim was
Multnomah               declared dead at the scene. The victim was wearing lap and shoulder
OR 2004-30-1            restraints.
Steep gravel road       A 67-year-old truck driver was killed while driving a 12 yd dump truck
                        loaded with crushed rock on a steep gravel road. At a left turn, the truck
Construction            continued to travel straight, leaving the roadway over the bank. The cab
Transportation          of the truck struck a large tree. The victim was assisted by other drivers
                        out of the cab, but died at the scene due to internal injuries. No major
July 2                  mechanical problems were discovered on later inspection of the vehicle,
Jackson                 but loss of brakes or overheating, due to the steep terrain, may have
OR 2004-14-1            contributed to the incident.

Water truck rollover    A 53-year-old female truck driver owner/operator was killed when her
                        log truck, hauling an empty water tank and pump, left a logging road and
Forestry/Logging        rolled over. Going downhill on a curve with a steep edge, the truck may
Transportation          have lost control due to soft dirt on the edge of the road. The driver was
                        ejected. No seat belts were installed in the vehicle.
July 9
Jefferson
OR 2004-44-1

Wheat truck             A 63-year-old farmer was killed when his fully loaded wheat truck ran
                        off the road. The farmer failed to negotiate a corner, and ran into a rock
Agriculture             embankment. The truck had several mechanical problems, including
Farm/Ranch              the brakes, which had recently been fixed. The truck also tended to
                        periodically pop out of gear. The farmer was not wearing a seat belt
July 26                 and was ejected from the vehicle. Speed was apparently not a factor
Sherman                 in the event, but the inertia of the heavy load, up to 46,000 lb, probably
OR 2004-46-1            accounted for the extensive damage to the cab of the truck.

Mining road             A 70-year-old miner was killed while moving dirt from his mining claim in
                        an old pickup truck. A partner was on foot ahead of the pickup, removing
Mining                  rocks from the steep and rugged road. The miner evidently lost control of
Construction            the vehicle and went over the edge. His partner saw him open the door in
                        an unsuccessful attempt to escape. The pickup rolled several times down
July 27                 a 300-400 ft hillside. The miner was ejected part-way down and was
Baker                   found dead at the scene.
OR 2004-47-1

Cement truck rollover   A 44-year-old truck driver was killed when the cement truck he was
                        driving tipped over on its passenger side on a left-hand turn with a slight
Manufacturing           grade. The road was asphalt and in good repair, but wet. The truck slid
Transportation          off the road into an embankment, crushing the cab. The driver was not
                        wearing a seat belt and was found dead on the passenger side of the
August 24               cab.
Lane
OR 2004-49-1


                                                20
                  Worker Fatalities – Transportation

Loose passenger door A 40-year-old female worker with a moving company was killed when she
                     fell from the passenger side of the moving truck while traveling on the
Transportation       highway. The passenger door on the truck had previous damage and did
Transportation       not shut properly. Resistance may have made it appear to be shut. The
                     worker was not wearing a seat belt. The victim was declared dead at the
September 20         scene.
Lane
OR 2004-50-1

Loaded log equipment A 42-year-old truck driver was killed when the surface of a logging road
                     gave way under his heavily loaded semi-truck and trailer. The driver was
Forestry/Logging     hauling a yarder to a new location and took an alternate route to avoid
Transportation       a weight-restricted bridge. A second truck was attached by a tow rope,
                     helping the rig climb a steep incline. The narrow road gave way under
September 22         the right rear tire of the trailer, and the rig was pulled over the edge. The
Lane                 cab was raised high in the air and the tow rope disengaged. The truck
OR 2004-33-1         rolled once before coming to rest 30-50 ft down the embankment in an
                     upright position. The victim was ejected and pinned beneath the wheels.

Dairy truck             A 30-year-old dairy truck driver was killed when his semi-truck and trailer
                        crossed over the center line of the highway, struck the guardrail on the
Transportation          opposite side, and traveled along the guardrail before crashing into an
Transportation          embankment. There were no adverse road conditions at the time of the
                        incident. The driver was not wearing a seat belt.
October 23
Jefferson
OR 2004-60-1
Delivery driver         A 57-year-old route manager for a home delivery service was killed in a
                        subdivision while making a delivery. The manager was hit by a pickup
Transportation          truck after he got out of his delivery truck and was standing next to the
Transportation          driver’s side door of his vehicle. The route manager was parked on the
                        opposite side of the street from the direction of travel of the pickup. The
October 28              victim died at the scene.
Washington
OR 2004-25-1
Log truck on road       A 48-year-old log truck driver was killed when he lost control of his
                        loaded truck on a highway curve and crashed over a steep embankment.
Forestry/Logging        The truck and trailer rolled over, crushing the cab. The victim was not
Transportation          wearing a seat belt and was found dead on the passenger side of the
                        cab.
November 1
Grant
OR 2004-58-1
Railroad crossing       A 56-year-old male ranch hand was killed while driving a pickup truck into
                        town to obtain a part needed for work. He failed to stop at an unguarded
Agriculture             railroad crossing and was struck by an oncoming train. The crossing had
Farm/Ranch              a stop sign, but no lights. The train conductor sounded the horn, but the
                        ranch hand apparently failed to hear it.
December 24
Klamath
OR 2004-63-1

                                                21
                   Worker Fatalities – Transportation



Transportation (Mobile Machinery)
Crushed foot            A 58-year-old supervisor at a recycling facility injured his lower leg while
                        riding a four-wheeled all-terrain vehicle at work, and died 4 months later
Admin/Support/          (Feb 27, 2004). The supervisor ran over his own left foot while turning
 Waste/Remediation      to avoid an oncoming tractor. He was treated at the hospital, released,
Management              and seen routinely for wound care. There was concern for vascular
                        supply to the lower extremity, due to a history of heart disease. On the
October 31, 2003        day of death, the supervisor experienced shortness of breath during a
Multnomah               scheduled check-up and was transferred to the emergency department,
OR 2004-28-1            where he eventually expired.
Nursery forklift        A 24-year-old Hispanic nursery laborer was killed while operating a skid-
                        steer loader. The operator was moving metal carts containing plants from
Agriculture             an outside location into a greenhouse. The operator was discovered in
Material Moving         a seated position in the operator’s cage of the skid steer with a severe
                        head injury. His left arm was behind him as if to support himself while
March 25                leaning forward. It was raining, and the operator had placed his coat
Marion                  across his lap to prevent his pants from getting wet. A pocket of the coat
OR 2004-07-1            was caught on the skid-steer’s operational hand controls. The controls
                        were probably activated as the victim leaned forward, causing the skid
                        steer to move suddenly. The jolt apparently caused his head to strike the
                        left-front roll bar. The victim was pronounced dead at the scene.

ATV rider              A 16-year-old dog trainer was thrown from an all-terrain vehicle, and died
                       4 days later. The trainer was riding the ATV with a passenger downhill
Other Services         into a pasture, and did not see a ditch grown over with vegetation. The
Personal Care/Services front wheels hit the ditch and the ATV rolled end over end. The trainer
                       was found unconscious next to the vehicle. He was not wearing a helmet
August 12              or other protective gear. The injured passenger took the ATV back to the
Columbia               employer to get help. The victim was taken to a hospital, but he was not
OR 2004-16-1           able to recover from severe chest and internal injuries.

Mill unloading          A 50-year-old log truck driver was killed in a mill yard when he was
                        crushed against his load of logs by a front-end loader. According to
Forestry/Logging        standard procedure, the loader moved forward to secure the load of
Transportation          logs to allow the driver to safely remove the last two wrappers. A second
                        loader operator working in the yard at the time saw a hard hat on the
September 23            ground near the truck, and radioed to the first operator to back away. The
Klamath                 victim was found dead at the scene, crushed between the loader and the
OR 2004-21-1            load of logs.
Forklift traffic lane    A 29-year-old female production worker was killed when she was struck
                        by a forklift carrying a load. The worker was stationed at a grading
Manufacturing           machine adjacent to a bay door and traffic area. She stopped to clear
Production              wood-block debris from the forklift traffic lanes. Clearing the lanes was
                        a common practice. A loaded forklift entered through the bay door and
November 30             struck the worker while she was bent over and not visible to the operator.
Jefferson               The forklift stopped abruptly, and the 1,300 lb load of wood tumbled
OR 2004-39-1            forward and crushed the victim.



                                                 22
                 Worker Fatalities – Transportation



Transportation (Air)
Helicopter logging      A 41-year-old helicopter pilot was killed during a logging operation in
                        a steeply sloped, tree-covered terrain. The helicopter was in a hover,
Forestry/Logging        attempting to snag a log using a 200 ft line, when it drifted sideways and
Transportation          the rear rotor struck a treetop. The helicopter then rolled and descended
                        to the ground. The pilot, a resident of Australia, had extensive
May 12                  experience as a helicopter pilot. The steep terrain evidently reduced the
Douglas                 safety margin for the length of the line over the treetops.
OR 2004-09-1
Training flight          A 70-year-old flight instructor was killed on a training flight in a student’s
                        recently purchased 1961 Piper Apache twin-engine airplane. The plane
Education Services      appeared to have engine trouble before crashing into an onion field. This
Education/Training      was the student pilot’s third instructional flight in the plane. The instructor
                        and student were both killed in the crash.
July 15
Malheur
OR 2004-55-1
Jet fighter              A 36-year-old U.S. Marine Corps pilot of an F/A-18 jet, and a 36-year-old
                        aircraft maintenance officer riding in the back seat, were killed in a mid-
Public Administration   air collision with another naval jet over the Columbia River. The jets were
Military                heading from Portland International Airport to the Boardman Bombing
                        Range. During the flight, the mission was rescheduled and the two
July 21                 planes were in the process of turning back to Portland when the rear jet
Gilliam                 collided with the lead jet. The pilot of the lead jet managed to parachute
OR 2004-45-2            to safety.



Transportation (Water)
Commercial crabbing     A 51-year-old commercial fisherman drowned after his 22 ft dory
                        capsized in the ocean. He was an experienced fisherman and skipper of
Fishing                 the vessel. The engine of the boat stalled as it was returning to harbor
Fishing                 from a crabbing trip. The U.S. Coast Guard responded to the craft and
                        was present at the scene. A crew member jumped off the stalled boat
June 9                  and was picked up by a rescue boat. The skipper went down into the
Lincoln                 cabin to get his survival suit before entering the water, and the vessel
OR 2004-32-1            capsized while he was below. The body was recovered, tangled in gear.

River excursion        A 51-year-old fishing guide was drowned when his drift boat wedged
                       sideways between two rock walls and capsized in a narrow section of
Arts/Entertainment/Rec the Rogue River with churning rapids. The guide was not wearing a
Personal Care/Services life preserver. Two passengers on board, both wearing life preservers,
                       emerged unharmed. The guide was responsible for rowing, which can be
September 30           uncomfortable while wearing a life preserver. The guide had conducted
Curry                  fishing excursions on the river for over 25 years. The victim’s body was
OR 2004-56-1           found 6 days later.


                                                 23
                       Worker Fatalities – Contact



Contact with objects/equipment
Tree falls wrong way    A 76-year-old self-employed logger, working as a faller, was killed by the
                        branches of a juniper that apparently fell in the opposite direction from
Forestry/Logging        the way it had been cut to fall. The faller’s partner discovered him at
Logging                 lunch time with no apparent signs of life. The victim’s chainsaw was lying
                        near the stump of the fallen tree. The fallers were in a remote location
January 26              with a poor road, and the victim’s partner drove the victim back to his
Lake                    residence before calling for help. The medical examiner concluded the
OR 2004-27-1            victim was already dead at the scene.
Debarker                A 24-year-old sawmill employee, working as a millwright, was killed in a
                        routine maintenance operation, grinding the teeth of the feed rolls inside
Manufacturing           a log debarking machine. The millwright shut down electrical power
Production              to the debarker before entering the intake area, but did not block the
                        holddown press roll with pins available on the frame of the machine.
February 7              The press roll was held up by compressed air. While he was inside the
Washington              debarker, another employee shut off the compressed-air system in a
OR 2004-03-1            separate maintenance operation, which allowed air pressure to drop
                        throughout the plant. As line pressure dropped, the press roll over the
                        intake area of the debarker descended and crushed the millwright.

Parked forklift         A 42-year-old Hispanic forklift operator was crushed between the
                        forklift he had been operating and a semi-trailer he was helping to load.
Manufacturing           Assisting the driver to tie down the load, the operator backed the forklift
Material Moving         to the side of the trailer, put the automatic transmission into neutral,
                        engaged the parking brake, and jumped out to take the strap thrown
February 10             across the load by the truck driver. The forklift’s engine was left running.
Hood River              While the operator was facing the trailer, the forklift engaged in reverse
OR 2004-04-1            and backed into him, crushing him against the trailer.

Tractor augur           A 33-year-old self-employed contractor was killed while operating a post-
                        hole augur attached to a tractor to install fence posts. The contractor
Construction            was hired by a friend to do some work on their land. The augur bit was
Construction            suspended from the ground and had not yet made a hole when the
                        contractor’s clothing apparently got caught on the rotating bit and pulled
February 22             him into it. There were no witnesses to the event. The victim was found
Deschutes               dead at the scene.
OR 2004-26-1

Drilling rig            A 47-year-old construction foreman was killed when he walked behind a
                        drilling rig at a large construction project. Construction was located on a
Construction            steep hillside, and several project subcontractors were in close proximity
Construction            as they worked. The foreman had 27 yrs of construction experience.
                        The drilling rig operator could not see the foreman from where he sat,
March 11                and was given no warning that a person was in the vicinity of the rig.
Multnomah               As the drilling operator rotated the drilling head, the rear of the platform
OR 2004-06-1            crushed the victims’ head against a concrete retaining wall. The injury
                        was immediately fatal.




                                                 24
                      Worker Fatalities – Contact
                           Worker Fatalities

Crane collapse          A 47-year-old technician, born in Yugoslavia and living in Canada, was
                        killed when a newly assembled 60-ton crane at a Columbia River port
Manufacturing           collapsed during testing. The technician was in the crane’s operator
Install/Maintain/Repair cabin about 60 ft off the ground. Investigation by the U.S. Occupational
                        Safety and Health Administration concluded the cause of the incident
April 27                was due to structural defects in the crane.
Morrow
OR 2004-08-1
Gradall starter         A 47-year-old co-owner of a wood-products firm, working as a general
                        contractor, was run over and killed by a Gradall rough-terrain forklift
Manufacturing           at a construction site. The contractor was operating the forklift and
Construction            momentarily stopped work. He left the machine in gear and it was
                        protected from starting again by a safety lock. The contractor was
June 4                  apparently unaware of this feature. He crawled underneath and reached
Linn                    up into the engine compartment with a screwdriver, made contact
OR 2004-10-1            between the two terminals on the starter, and jump-started the engine.
                        The parking brake was not set and the Gradall rolled forward over him.

Super sacks             A 39-year-old forklift operator of Hispanic origin was killed by a 2,200
                        lb super sack of expandable polymer beads that tipped over on top of
Manufacturing           him. The super sacks were stacked two high. The operator accidentally
Transportation          punctured the lower super sack with the fork of his forklift. He moved
                        the forklift out of the way and was busy patching the hole with tape to
June 29                 prevent the sandlike beads from spilling out when the super sack above
Clackamas               fell over on top of him. The victim was declared dead at the scene.
OR 2004-13-1

Hydraulic press         A 20-year-old machinist was killed while setting up a hydraulic press to
                        punch holes in metal tubing. While changing the punch on the press, the
Manufacturing           machinist drew back the cylinder all the way, which exerted maximum
Production              pressure. The pressure gauge on the press was not operational. The
                        machinist was sitting on a small rolling cart directly in front of the 5,000
July 14                 lb press, when a fitting to the hydraulic hose burst, broke free from the
Linn                    hose, and struck him in the chest. The victim was found dead at the
OR 2004-15-1            scene.
Fixing brakes           A 63-year-old truck driver was killed while working on his front brakes
                        at a truck stop. The driver asked another driver to get in and start the
Transportation          engine, while he was still underneath the vehicle. The transmission was
Transportation          engaged, and turning the starter caused the truck to lurch forward. The
                        front tire ran over the driver.
August 17
Marion
OR 2004-57-1

Runaway pickup          A 28-year-old hooktender was killed on an active logging site by a pickup
                        truck. The incident was not witnessed. The pickup was discovered on a
Forestry/Logging        slight incline, with the hooktender pinned underneath it. The transmission
Logging                 was in neutral. Apparently the engine stalled, and the hooktender may
                        have been underneath working on the starter, or had attempted to push
September 7             the vehicle. An hour before the incident, the starter failed and the pickup
Clatsop                 had to be push started. The victim was reportedly aware that the parking
OR 2004-18-1            brake on the pickup was not functioning properly.

                                                25
                      Worker Fatalities – Contact

Forklift floor jack      A 27-year-old mechanic was killed underneath a forklift when it slipped
                        off the jack holding it up during maintenance. The mechanic was
Retail Trade            performing warranty maintenance work on the forklift, which involved
Install/Maintain/Repair changing the starter. He placed a floor jack under the rear axle at the
                        center of the counterweight, and raised it to the maximum extension.
September 9             While the mechanic was underneath, loosening the nuts on the starter,
Umatilla                the jack slipped out and allowed the forklift to drop.
OR 2004-19-1

Hung tree               A 58-year-old timber faller was killed by a small fir tree hung up in a
                        larger tree he was falling. Cutting a strip with his partner, the pair were
Forestry/Logging        working their way uphill. Days earlier, a 6 in. diameter fir, about 45 ft tall,
Logging                 fell uphill and caught between two trees. The small tree was not marked
                        with a danger ribbon. On the day of the incident, the faller cut a tree
September 28            uphill from the “hung” tree, and as the tree fell, the small fir tree also fell,
Tillamook               striking the faller. The victim was transported to paramedics and declared
OR 2004-22-1            dead.

Bulldozer choker        A 52-year-old ranch hand was killed during a logging operation while
                        operating a D4E Caterpillar to haul logs to a landing. The ranch hand
Agriculture             was an experienced logger. With the engine left running, gear in reverse/
Logging                 neutral, parking brake set, and front blade raised about 1 ft off the
                        ground, the ranch hand was setting chokers to logs behind the bulldozer.
September 30            The bulldozer was on a slight incline and the tracks were on branches.
Coos                    As the ranch hand leaned down, the bulldozer dislodged and slid
OR 2004-23-1            backward. The victim was killed immediately.

Yarder turn             A 47-year-old logger, working as a choker setter, was hit by a treetop in
                        a cable logging operation, and died 7 days later. Working with a partner,
Forestry/Logging        the choker setter may have been “crowding the rigging” – standing
Logging                 too close to the cable path as the yarder began to pull the load of logs
                        uphill. A small tree within the load was being held down by another tree,
November 1              and immediately as the load moved, the treetop broke loose and hit
Douglas                 the choker setter in the stomach. He was admitted to the hospital with
OR 2004-52-1            serious internal injuries.

Moving bus              A 56-year-old female bus driver was run over by the city bus she had
                        been driving. The driver stopped at a transit center to let off passengers,
Transportation          and exited the bus to take a scheduled break. She left the engine running
Transportation          and walked to the driver’s side to reach in the window, probably to close
                        the door. The bus began to move forward and the driver ran to the front
November 2              with outstretched arms, apparently trying to stop the 15-ton vehicle. The
Washington              bus ran over her. How the bus could have moved forward on flat ground
OR 2004-34-1            remains uncertain. The parking brake was apparently set.

Faller snag             A 65-year-old independent logger, working as a faller, was killed when
                        a snag tree swung back and struck him. The faller was working with a
Forestry/Logging        spotter. He cut an 80 ft pine tree, and the branches caught another tree
Logging                 as it was falling. The snag bent in the direction of the fall, then swung
                        back and broke. The spotter ran and avoided the tree. He found the faller
November 5              on the ground near the tree, seriously injured. By the time emergency
Jackson                 responders arrived, the victim was dead at the scene. Reportedly, the
OR 2004-35-1            initial cut of the fallen tree was performed correctly to avoid the snag.


                                                 26
                     Worker Fatalities – Exposure



Exposure to harmful substance/environment
Shovel shock            A 34-year-old machine operator was electrocuted while cleaning up
                        wood pellets from beneath a pellet bag sealing machine and its conveyor
Manufacturing           system. The operator was using a long-handled scoop shovel to push
Production              spilled wood pellets into a central pile. He grasped a metal guard on the
                        bagging machine with his left hand and leaned forward with the shovel
January 28              in his right hand. His right wrist came into contact with exposed electrical
Linn                    controls on the wall near the bagging machine. The victim collapsed, and
OR 2004-05-1            was later discovered by a coworker, deceased.

Tanker confined space A 23-year-old tank mechanic died when he entered a permit-required
                        confined space. The mechanic was assigned to prepare for an inspection
Manufacturing           of a shipping container used to transport silicon tetrachloride. The tank
Install/Maintain/Repair had been purged with an inert nitrogen atmosphere. While waiting for the
                        inspector, the mechanic entered the tank without testing the atmosphere,
February 4              passed out, and died of asphyxiation. Upon discovering the victim about
Multnomah               45 min. later, a coworker jumped into the tank, also without testing the
OR 2004-02-1            atmosphere, and lifted the victim up to others standing on top of the tank.
                        Testing showed the atmosphere at the bottom of the tank to be about
                        12% oxygen, below the minimum safe level of about 20% oxygen.

Gravel hopper           A 33-year-old maintenance worker was killed when he was engulfed
                        by sand and gravel that had plugged a 30-ton transfer hopper. The
Mining                  maintenance worker and two coworkers succeeded in unplugging the
Install/Maintain/Repair discharge point for the hopper, but a bridge of pit material had built up
                        and blocked the upper section. The maintenance worker entered the
June 19                 hopper from the top and was standing on the material when it broke free
Columbia                and engulfed him. He was not wearing a safety harness. The victim was
OR 2004-12-1            pronounced dead at the scene, due to traumatic asphyxiation.

Propane buffer          A 50-year-old janitor died by carbon-monoxide poisoning, due to exhaust
                        from a propane buffer he was using in an enclosed space. The janitor
Admin/Support/          was found on the floor, unresponsive, 6 ft from the propane-powered
 Waste/Remediation      buffer, which was propped up in idle mode, still running. The odor of
Building/Grounds        exhaust in the office building was overwhelming when the janitor’s
 Maintenance            employer entered to locate him several hours after he should have
                        been done with the job. The air filter on the buffer was clogged, and
November 13             the exhaust contained very high concentrations of carbon monoxide,
Deschutes               immediately harmful to life and health.
OR 2004-37-1




                                                27
                       Worker Fatalities – Falls



Falls
Fall from ladder      A 68-year-old female retail clerk fell from the sixth step of a step ladder
                      in a company storeroom, and died 5 days later. She sustained a fracture
Retail Trade          to the left knee and femur. The clerk was admitted to a local hospital,
Food Prep & Related   where she developed sepsis, and died on the way to another hospital
                      for advanced care. Cause of death remains uncertain. The only unusual
January 1             result found by the medical examiner was an “extensive infarcted colon,”
Multnomah             which did not appear to be associated with the fracture.
OR 2004-01-1

Hole in roof          A 45-year-old journeyman roofer died after falling through a covered hole
                      during a reroofing project on a warehouse and office space. The roofer
Construction          was working with another journeyman roofer and an apprentice to lay
Construction          insulation. The workers removed an exhaust fan, and covered the hole
                      with a square of insulation, left unsecured and unmarked. The roofer,
June 17               wearing sunglasses against the glare from the insulation, walked across
Multnomah             the roof, kicked loose the insulation over the hole, and fell about 20 ft to
OR 2004-11-1          the concrete floor below. He was transported to the hospital, where he
                      died a half-hour later.

Crash off ladder      A 54-year-old Asian female cafe owner was critically injured after falling
                      9-10 ft off a ladder onto her head, while attempting to repair a light
Accommodation/Food    fixture. She died 2 days later in the hospital. The event was unwitnessed.
 Services             No mark was evident, but the victim’s balance may have been upset by
Management            an electric shock.

June 26
Washington
OR 2004-43-1

Conveyor belt         A 63-year-old miner fell 12 ft onto a concrete floor from a crossbeam of
                      an elevated conveyor at a sand and gravel operation, and died the next
Mining                day. The miner and two coworkers were installing a new conveyor belt.
Construction          The miner was standing on a crossbeam, pulling on a rope tied to the
                      new belt. The rope unexpectedly came loose, causing him to fall.
August 21
Clackamas
OR 2004-17-1




                                              28
                      Worker Fatalities – Falls


Torch-cut supports   A 67-year-old salvage worker fell from a steel structure he was cutting
                     with a torch, and died nearly 3 weeks later. The worker was cutting steel
Construction         supports to salvage a log in-feed conveyor system, and stepped onto
Construction         a support that had already been cut, thinking it would hold him. The
                     support gave way and the worker fell nearly 6 ft and struck his head on
August 30            the concrete floor.
Benton
OR 2004-36-1

Loading-hole gate    A 39-year-old Hispanic female fish processor was killed after falling
                     through a loading hole from a second-story storage area. The processor
Manufacturing        and other employees were boxing frozen fish, and went to get more
Production           boxes upstairs. The processor remained upstairs to prepare more
                     boxes. The boxes brought down were the wrong kind and needed to be
September 15         returned to storage, and the processor leaned through the loading hole
Coos                 to retrieve them from coworkers. The opening was designed for use by
OR 2004-20-1         a forklift to set items upstairs for storage; three sides were closed by
                     fixed guardrails, and the fourth had a removable gate, consisting of two
                     2x4 rails that sat in cradles. The rails were not pinned or blocked. As the
                     processor leaned over the bottom rail of the gate to catch boxes being
                     thrown up to her, the rail dislodged and she fell 12 ft to the floor below.

Trip fracture        An 88-year-old pawnbroker tripped over a bag on the floor of his shop
                     and fractured his hip, and died in the hospital 4 days later. Surgery was
Retail Trade         performed for the hip fracture, and the victim died from post-surgery
Management           complications. There was concern about atrial fibrillation, which the
                     pawnbroker had experienced previously following surgery.
September 22
Washington
OR 2004-51-1

Fall from ladder     A 67-year-old sales person at a retail store fell 3-4 ft off a stepladder onto
                     his head, and died the next day. The worker was arranging a top shelf,
Retail Trade         and fell backwards while pulling products forward.
Sales & Related

December 3
Coos
OR 2004-38-1




                                              29
                      Worker Fatalities – Violence



Violence
Suicide drowning          A 67-year-old operator of an auto repair shop was discovered in a
                          50-gallon tub of water, held under by a weighted object.
Other Services
Install/Maintain/Repair

June 4
Jackson
OR 2004-31-1

Overpass                  A 45-year-old female motel owner of Asian origin suffered a fractured
                          back in a fall from a highway overpass, and died of hyperthermia due
Accommodation/Food        to environmental exposure. The body was discovered 2 days after the
 Services                 motel owner was reported missing under suspicious circumstances. It
Management                remains uncertain whether the victim jumped, fell, or was thrown from the
                          bridge. The location of the overpass was 1¾ miles from the motel.
July 9
Multnomah
OR 2004-61-1

Woodworker suicide        A 72-year-old cabinetmaker was found in his shop after committing
                          suicide by hanging at an unknown earlier date.
Manufacturing
Construction

December 24
Multnomah
OR 2004-62-1

Tow truck murder          A 67-year-old gas-station owner and tow-truck driver was murdered by
                          a client, whose car he went to pull from a snowy ditch late at night. The
Transportation            victim was shot several times in the chest.
Transportation

December 26
Klamath
OR 2004-40-1




                                                  30
                   Worker Fatalities – Overexertion



Overexertion
Physical fitness exam    A 51-year-old forester died during a physical work capacity test,
                        presumably from heart failure. The forester managed field forestry
Forestry/Logging        programs, including fire control activities that were highly stressful. He
Forestry                had worked with the Department of Forestry over 28 years. The physical
                        test, called a “pack test,” required a 3-mile walk carrying a 40 lb pack
June 5                  within a set time.
Wasco
OR 2004-64-1



                             Contact Information

    The Center for Research on Occupational and Environmental Toxicology (CROET)
    at Oregon Health & Science University performs OR-FACE investigations through a
    cooperative agreement with the National Institute for Occupational Safety and Health,
    Division of Safety Research. Dedicated to preventing workplace injuries, OR-FACE
    investigations evaluate the working environment, the worker, the activity, the tools, the
    energy exchange, and the role of management in fatal occupational incidents.

    Oregon Fatality Assessment and Control Evaluation
    Center for Research on Occupational and Environmental Toxicology
    Oregon Health & Science University
    3181 SW Sam Jackson Park Rd, L606
    Portland, OR 97239-3098
    Phone (503) 494-2502
    Email: orface@ohsu.edu
    Web site: http://www.ohsu.edu/croet/face/


    Published in July 2006
    The material in this report is public information and may be freely copied and distributed.
    Population Data Sources
    U.S. CENSUS
    http://www.census.gov (American Factfinder, Data Sets, Summary File 3)
    BUREAU OF LABOR STATISTICS
    http://stats.bls.gov/ces/
    LAUS – LOCAL AREA UNEMPLOYMENT STATISTICS
    http://www.bls.gov/lau/
    OLMIS – OREGON LABOR MARKET INFORMATION SYSTEM
    http://olmis.emp.state.or.us/olmisj/CES?x=1&y=1&p_action=


                                                31
                  Oregon Fatality Assessment & Control Evaluation
                                   Center for Research on Occupational
                                             and Environmental Toxicology
                                                                  Mailcode L606
                                      3181 SW Sam Jackson Park Road
                                                   Portland OR 97239-3098


                   OHSU includes the schools of Dentistry, Medicine, Nursing, and
Science & Engineering; OHSU Hospital; Doernbecher Children’s Hospital; numerous
                     primary care and specialty clinics, multiple research institutes;
                               and several outreach and community service units.
                          OHSU is an equal opportunity, affirmative action institution.

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